A rare case of multiple bronchial artery aneurysms associated with a double aortic arch

Endovascular Treatment of Primary Bilateral Racemose Hemangioma With Multiple Bilateral Bronchial Artery Aneurysms: A Case Report and Review of Literature

A 36-year-old man was presented with hemoptysis. The contrast enhanced chest computed tomography and bronchial angiography revealed multiple bilateral ostial and intraparenchymal bronchial artery aneurysms (BAA) and bilateral primary Racemose hemangioma (PRH). Endovascular embolization with polyvinyl alcohol and n-butyl-2-cyanoacrylate was preferred to occlude the BAAs. Five days after the procedure, the patient was discharged and remained stable without recurrence over the 6 month follow up. To the best of our knowledge, this is the first case of PRH with multiple bilateral BAAs and the second published case of bilateral BAAs. This study aims to describe the successful treatment method employed for management of this rare condition and review the published articles relating to BBA and PRH.

Open surgical correction of multiple bronchial artery aneurysms

BACKGROUND

Bronchial artery aneurysms (BAAs) are a rare vascular entity. They can have various presentations ranging from an incidental finding on radiological examination to life-threatening hemoptysis.

MATERIAL AND METHODS

We report the case of a 60-year-old woman with three posterior mediastinal BAAs who presented with unilateral periscapular pain, shortness of breath, hoarseness, and dysphagia. The BAAs were removed successfully via thoracotomy, with excellent recovery and relief of the periscapular pain.

DISCUSSION AND CONCLUSION

We use this case as a platform to discuss the treatment options for BAAs.

Endovascular Treatment of Multiple Bronchial Artery Aneurysms With Prominent Fistula to Pulmonary Artery in a Patient With Interstitial Lung Disease: A Case Report and Literature Review

Bronchial artery aneurysm (BAA) is a rare entity. Ruptured BAA can cause life-threatening hemorrhage. It is recommended that treatment should be initiated immediately after diagnosis. We present the case of a 56-year-old female with multiple BAAs and interstitial lung disease. Aortic computed tomography angiography demonstrated that the largest aneurysm at the right hilum was fed by right subclavian artery and right bronchial artery. A fistula between the pulmonary trunk and the aneurysm was also revealed. The patient underwent transcatheter embolization. Coils were placed in the feeding vessels instead of the aneurysms to avoid nontarget embolization of the pulmonary arteries through the fistula. The procedure achieved reduction in aneurysmal blood flow. The patient's cough resolved at 6-month follow-up.

Massive hemoptysis due to multiple bronchial artery aneurysms and multiple aneurysmal dilations: A case report

Bronchial artery aneurysm (BAA) is a rare but potentially life-threatening clinical entity. Patients with multiple BAAs and multiple aneurysmal dilations are even rarer. In this case report, we will investigate a case of multiple BAAs and multiple aneurysmal dilations arising from 2 right bronchial artery branches presenting with hemoptysis. The patient was successfully treated with transcatheter arterial embolization. We should be vigilant for the possibility of BAA when encountering patients presenting with hemoptysis. Transcatheter arterial embolization is safe and effective to solve this condition.

Embolization of a Bronchial Artery Aneurysm in a Chronic Obstructive Pulmonary Disease (COPD) Patient with Non-Massive Hemoptysis

Background

Bronchial artery aneurysm (BAA) is a rare condition with a reported prevalence of less than 1% of all selective bronchial arterial angiograms. Despite its low incidence, BAA represents a potential cause of hemoptysis.

Case Report

We describe the case of a 63-year-old man suffering from chronic obstructive pulmonary disease (COPD), who presented with non-massive hemoptysis.

CT angiography revealed a single bronchial artery aneurysm of 9 mm in diameter, abutting the esophageal wall.

Other CT findings included hypertrophy of the bronchial arteries along the mediastinal course, diffuse thickening of the walls of numerous bronchial branches and a “ground glass” opacity in the anterior segment of the right upper pulmonary lobe suggestive of alveolar hemorrhage.

The final diagnosis was established based on selective angiography, which was followed by transcatheter arterial embolization (TAE) of the BAA and of the pathological bronchial circulation.

Follow-up CT scans revealed a total exclusion of the aneurysm from the systemic circulation, resolution of the parenchymal “ground glass” opacity and absence of further episodes of hemoptysis over a period of two years.

Conclusions

An incidental finding of a bronchial artery aneurysm necessitates prompt treatment.

CT angiography and TAE represent the methods of choice for an appropriate diagnosis and treatment, respectively.

In case of a BAA associated with chronic inflammatory diseases, such as COPD, in patients with hemoptysis, TAE of the BAA and of the pathological bronchial circulation, in association with the treatment of the underlying disease, represents a valid approach that can improve the pulmonary status and prevent further episodes of hemoptysis.